Adrenocortical Carcinoma: Update of Clinical Features and Diagnosis

Gurzu, Simona; Jung, Ioan

doi:10.12974/2309-6160.2013.01.01.6

Cited by 4 publications

(10 citation statements)

References 34 publications

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“…ACC rarely associates lymphatic-borne metastases in the mediastinal or neck lymph nodes; however, the systemic metastases are frequent, being distributed throughout the body, without a specific spreading pathway. 1 , 6 In most of the cases, the liver and lung are affected, followed by the bone and peritoneum. 1 , 6 Other organs were also reported to be involved, such as ovaries, skin, brain, pancreas, spleen, and tongue.…”

Section: Discussionmentioning

confidence: 99%

“… 1 , 6 In most of the cases, the liver and lung are affected, followed by the bone and peritoneum. 1 , 6 Other organs were also reported to be involved, such as ovaries, skin, brain, pancreas, spleen, and tongue. 1 , 6 To our knowledge, no gastric metastases have been reported to date (March 2015).…”

Section: Discussionmentioning

confidence: 99%

“… 1 , 6 Other organs were also reported to be involved, such as ovaries, skin, brain, pancreas, spleen, and tongue. 1 , 6 To our knowledge, no gastric metastases have been reported to date (March 2015). In our case, submucosal gastric metastasis was the reason of hospitalization, being confused with a primary gastric cancer.…”

Section: Discussionmentioning

confidence: 99%

“…The differential diagnosis between primary ACC, pheochromocytoma, and a metastatic tumor is difficult to be performed, it being based on a proper correlation between clinicopathological and immunohistochemical aspects. 5 , 6 …”

Section: Introductionmentioning

confidence: 99%

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First Case Report of a Sporadic Adrenocortical Carcinoma With Gastric Metastasis and a Synchronous Gastrointestinal Stromal Tumor of the Stomach

Kövecsi

Jung²,

Bara

et al. 2015

Medicine

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Adrenocortical carcinoma is a rare tumor with high aggresivity that can associate systemic metastases.A 71-year-old man was hospitalized for gastric cancer. The abdominal computed tomography also revealed a tumor above the right kidney. Total gastrectomy and right adrenalectomy were performed. The encapsulated tumor of the adrenal gland weighed 560 grams and presented diffuse tumor architecture under microscope, with capsular, sinusoidal, and vascular invasion. The large tumor cells had a polygonal shape, with slight basophilic, eosinophilic, or vacuolated cytoplasm, pleomorphic nuclei, and a high mitotic rate. In the stomach, the protruded tumor was covered by normal mucosa; under microscope, the tumor cells were observed only in the submucosal layer. In primary adrenal tumor and gastric metastasis the tumor cells were marked by vimentin, inhibin, synaptophysin, neuron-specific enolase, and calretinin. Based on these criteria, the diagnosis of adrenocortical carcinoma (ACC) with gastric metastasis and no lymph node metastases was established. A synchronous 10 × 10-mm-sized gastrointestinal stromal tumor (GIST) of the stomach, without mitoses, was also identified.So far, as we know, this is the 15th case of ever reported synchronous/metachronous sporadic ACCs; the ACC-related gastric metastases either synchronous ACC and GIST, has not been reported in the literature previously.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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First Case Report of a Sporadic Adrenocortical Carcinoma With Gastric Metastasis and a Synchronous Gastrointestinal Stromal Tumor of the Stomach

Kövecsi

Jung²,

Bara

et al. 2015

Medicine

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“…An unusual case of adrenocortical carcinoma with liver metastasis that occurred at 23 years after surgery parameters, the tumor was defined as an ACC (5). No microvascular involvement nor capsular infiltration were observed.…”

Section: Case Reportmentioning

confidence: 99%

An unusual case of adrenocortical carcinoma with liver metastasis that occurred at 23 years after surgery

Bergeat¹,

Rayar²,

Beuzit³

et al. 2016

Hepatobiliary Surg. Nutr.

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Adrenocortical carcinoma (ACC) is an uncommon and aggressive cancer occurring more frequently in women; local or distant recurrences occur in 80% of cases, typically within 1 year after curative resection. Liver is the preferred metastatic site. Herein, we report the case of a unique liver metastasis from ACC occurring 23 years after the curative prior tumor surgery. A 45-year-old woman was operated in 1991 for adrenocortical stage II without microvascular involvement or capsular infiltration. At that time, no adjuvant treatment was indicated. The initial surgery consisted on a left adrenalectomy with contemporaneous left nephrectomy and regional lymphadenectomy. Five years after surgery, the patient was considered cured. However, 23 years later, the patient presented an atypical right subcostal pain. A 4 cm liver ACC metastasis involving the segment 4 and initially diagnosed as a hemangioma was discovered. A curative resection of the segment 4 was performed. Final pathological examination confirmed the diagnosis of ACC metastasis with a complete R0 resection; no lymph node metastases were observed. This case is the latest metachronous ACC metastasis ever reported in literature. To date, the patient is alive with no signs of recurrence after a post-surgical follow-up of 13 months.

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Clinicopathological Features Associated With the Prognosis of Patients With Adrenal Cortical Carcinoma

Choi

Kwon²,

Jeon³

et al. 2016

Medicine

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Adrenocortical carcinoma (ACC) is a rare tumor with a poor prognosis. Identification of clinicopathological features and molecular prognostic markers is important for the treatment of ACC. The aim of this study was to evaluate the clinical and histopathological features of ACC for prognostic prediction.This retrospective cohort study included 86 patients pathologically confirmed with ACC in a single center. Ki-67 index was evaluated by immunohistochemical staining of paraffin-embedded samples.The median age of the 86 (46 male and 40 female) patients with ACC was 49 years old (range 21–78), and the mean primary tumor size was 12.2 ± 5.2 cm. ACCs were incidentally found in 29 patients (34%). Three patients (3%) had bilateral ACC, and 59 patients (69%) had distant metastasis (37 synchronous and 22 metachronous). Twenty-four patients (28%) had symptoms from hormone excess or mass effects, and 25 patients (29%) had nonspecific symptoms. The 5-year survival rate for ACC was 28%. Sixty patients underwent surgical treatment, including 37 patients with an R0 resection. Tumor size, Ki-67 index, stage, and resection status were independently associated with overall survival by multivariate analysis. In patients with R0 resection, recurrence was significantly associated with larger tumor size and functional tumor.Tumor size, Ki-67 index, stage, and resection status are important prognostic indicators of survival in ACC patients.

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Adrenocortical Carcinoma: Update of Clinical Features and Diagnosis

Cited by 4 publications

References 34 publications

First Case Report of a Sporadic Adrenocortical Carcinoma With Gastric Metastasis and a Synchronous Gastrointestinal Stromal Tumor of the Stomach

First Case Report of a Sporadic Adrenocortical Carcinoma With Gastric Metastasis and a Synchronous Gastrointestinal Stromal Tumor of the Stomach

An unusual case of adrenocortical carcinoma with liver metastasis that occurred at 23 years after surgery

Clinicopathological Features Associated With the Prognosis of Patients With Adrenal Cortical Carcinoma

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